Sierra L. Rev. Nutr. Clin. Metab. 2021;4(Supl.1):5-6.
Back to the basics
Volver a lo básico
Voltar ao básico
Lina María Sierra Tobón*
https://doi.org/10.35454/rncm.v4supl1.342
*Corresponding author: Lina María Sierra Tobón.
integralclinicalnutrition@gmail.com
On June 30 of 2000 I was awarded the diploma that attests to my professional training as Nutritionist-Dietician. I raised my glass that day to what I though was the end, oblivious to the fact that it was only the beginning.
Although the end still seems to be far away after 21 years, it concerns me increasingly less; on the contrary, my enthusiasm is focused now on the possibility of going back to basics, without having to start all over again. It is because the basics, understood as what is fundamental (primordial) and not only elementary (simple), can provide answers to many questions fallen by the wayside over time. We can agree that basics may not mean the same to you as it means to me, but in referring to a group of people who have chosen to train as professionals in nutrition, we can find shared interests as a convergent point of departure.
Nutritional care as a shared interest
According to Ester Busquets,(1) care is inherent to human beings. This author states that “If we do not provide care or receive it when we need it, and if we do not feel committed when faced with the vulnerability of others, the foundations of care professions collapse and naturally so those of mankind as well.”
Actually, after the Cartagena International Declaration on the Right to Nutritional Care and the Fight Against Malnutrition,(2) nutritional care has been established in different academic training settings as the raison d’être of those of us who are passionate about nutrition. That is how thirteen principles provide a framework that promotes nutritional care, enabling infirm patients to receive nutritional therapy with dignity.
If we extrapolate this to the current situation in which the pandemic has, in a way, enabled deeper reflection, we can find meaning in care as a point of convergence. According to Busquets,(1) “Society trusts that no matter what happens in the lives of the people, healthcare professionals will be there to look after them.” And that is who we are: healthcare professionals; and that is what we do: care for people.
We trained to be responsible for the nutritional care of our patients and we continue to learn how to look after their nutrition as best we can; we read publications based on scientific evidence; we lead knowledge creation through research; we participate in academic seminars; we attend refresher courses and we even enrol in graduate courses because we want to be sure that we are doing things the right way.
We have come to realize that nutritional care is an emerging human right that is closely linked to fundamental human rights such as the right to food, the right to health and, of course, the right to life. We have taken on a leading role in ensuring timely and adequate nutritional management for our patients, and we have done so responsibly and firmly.
Despite all of this, the aim of this special edition on Bioethics and Human Rights in Clinical Nutrition is to look beyond academic training and go back to basics in order to approach current matters directly related to nutritional care and which guide potential responses to various situations from an ethical stance, not only from the perspective of knowing but also from the perspective of being.
The ethics of care
Ethics as a discipline that appraises our actions is a critical element of professional training. According to Valera,(3) “Ethics is not arbitrary, it is a rational discipline with universal truths, albeit applied differently in the various areas of practice.”
In clinical nutrition practice, applied ethics allows to propose recommendations for action which, as previously stated, is based on nutritional care of the person in a condition of vulnerability from the nutritional point of view.
Busquets says the following:(1) “Vulnerability inherent to human nature requires care as an ethical response to this precariousness. The ethics of care consists of striving to affirm an ethical response in the face of fragility.”
Nutritional care being considered a point of convergence in training, it must be guided by principles and standards conducive to rigorous ethical and scientific professional practice.
This edition includes the work of professionals who approach current topics from an ethical perspective, inviting us to nurture what we are, care for what we do, care for our profession and those who practice it and, of course, care for our patients who, in their overt vulnerability expect no other thing from us than the care we can provide.
Finally, if as nutritionists we recognize nutritional care as the essence of our professional ethos, we will be able to go back to basics without having to start all over again and, paraphrasing an old reflection in medicine, work not only to be good but also kind nutritionists.
Lina María Sierra Tobón
School of Medicine, Clínica Alemana, Universidad del Desarrollo. Santiago, Chile. https://orcid.org/0000-0002-4353-6863
References
- Busquets Alibés E. Ética del cuidado en ciencias de la salud: a partir de la lectura de La muerte de Iván Ilich de Lev Tolstói. Barcelona: Herder; 2019.
- Cárdenas D, Bermúdez C, Echeverri S, Pérez A, Puentes M, López L, et al. Declaración de Cartagena. Declaración Internacional sobre el Derecho al Cuidado Nutricional y la Lucha contra la Malnutrición. Nutr Hosp. 2019;36(4):974-80. doi: 10.20960/nh.02701.
- Valera L, Carrasco MA. Manual de ética aplicada: de la teoría a la práctica. Chile: Universidad Católica de Chile; 2021.